Shoulder Arthroplasty

WHAT YOU SHOULD KNOW:

Shoulder arthroplasty (AHR-thro-plaste) is surgery to replace the shoulder joint. The shoulder joint is where the head (ball) of the humerus meets the glenoid (socket-like end) of the scapula. The humerus is the bone of the upper arm, and the scapula is the shoulder blade. Arthroplasty is usually done in patients with shoulder problems that cause severe or constant pain. These problems include pain from arthritis with narrowing of the joint space or bone spur formation. They may also include non-healing broken bones, severe muscle tears, and bone thinning or softening. Shoulder arthroplasty may help ease pain, increase movement, improve strength, and make the shoulder joint more stable.

Shoulder arthroplasty may be done to replace the humeral head or both the humeral head and glenoid. Surgery to replace both the ball and socket is called total arthroplasty. If only the ball of the humerus is replaced, it is called hemiarthroplasty. Hemiarthroplasty has a shorter surgery time and a lower risk for shoulder weakness than total arthroplasty. Total shoulder arthroplasty, however, provides better pain relief and allows more active shoulder movement. The type of surgery to be done will depend on what and how severe your shoulder problem is. You and your caregiver will decide which type of shoulder arthroplasty is right for you.

In shoulder arthroplasty, caregivers remove the ball of the humerus and replace it with a prosthetic (man-made) implant. The implant consists of a ball, often made of metal, and a stem, which is inserted into the humerus. Caregivers will choose a ball and stem according to the size and shape of your bone. If needed, caregivers may also replace the socket with a plastic glenoid implant. After surgery, you will need physical therapy to help improve your arm movement. It may take up to two years of rehabilitation to get full function and motion after shoulder arthroplasty.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Pain medicine: You may need medicine to take away or decrease pain.

Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Ask your caregiver when you need to return to have your shoulder wound checked and the stitches removed.

Activity:

Avoid doing hard activities, such as heavy lifting, pulling, and pushing. You may also need to limit your shoulder movement, especially outward rotation. Do not use your arm to push yourself up in bed or from a chair.

Avoid playing hard or contact sports for some time. Do not play sports that put great stress on your shoulder, such as football, gymnastics, hockey, or rock climbing.

Do not do movements that cause pain. Avoid actions that may make your shoulder joint pop or snap. A sudden increase in activity or jerky, forceful movements could again injure your shoulder.

Do not let your affected shoulder get wet unless your caregiver says it is OK. Ask your caregiver when you will be allowed to bathe, shower, or swim.

Physical therapy:

You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

Do light and easy exercises at first after your surgery. These may include pendulum, elbow, wrist, and hand exercises. Pendulum exercises are done by bending over at the waist and letting the affected arm hang down. Some exercises are best done while lying down to decrease stress caused by gravity. This also helps keep the shoulder blade stable while moving the arm and shoulder.

Your physical therapist may teach you special exercises to do at home. These may be done alone or with the help of a family member, 4 to 5 times daily. Do only the exercises advised by your caregiver and do them only as often as your caregiver suggests. Do not do more than the range of motion exercises advised by your caregiver.

You may be asked to do more as you get stronger and as the pain decreases. Rotation exercises, exercises in the standing position, stretching, and resistance exercises may be added to your program over time.

Wearing an arm sling or splint:

Your caregiver may want to keep your shoulder from moving for some time. A sling may be applied after the splint is removed. A sling may be used to strap the arm close to the body using a bandage. Wearing a sling may help your shoulder heal faster and also make you feel more comfortable. Always wear your sling when going out of the house. You may take it off at home to use the arm for waist-level activities, such as eating, dressing, and bathing.

Wound and drain care:

When you are allowed to bathe or shower, carefully wash the incision with soap and water. Afterwards, put on clean, new bandages. Change your bandages every time they get wet or dirty. Always check your drain when changing your bandages. Do not pull it out. Ask your caregivers for more information about wound and drain care.

CONTACT A CAREGIVER IF:

You have a fever.

You have chills, a cough, or feel weak and achy.

You have more pain and swelling in your shoulder even after taking pain medicines.

Your skin is itchy, swollen, or has a rash.

You have questions or concerns about your condition, surgery, or medicine.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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